Solera J, Medrano F, Rodríguez M, Geijo P, Paulino J
Servicio de Medicina Interna, Hospitales Generales de Albacete, Cuenca.
Med Clin (Barc). 1991 May 4;96(17):649-53.
Comparison and evaluation of the efficacy and safety of two treatment schedules in human brucellosis.
A comparative, randomized, multicentric, open study of 45 days doxycycline plus rifampin in the initial 21 days (group A) versus 45 doxycycline plus streptomycin in the initial 14 days (group B). 42 were included in each group. The diagnosis of brucellosis was based on blood culture or consistent clinical findings and a Wright's serum agglutination titer of 1/160 or greater. Clinical and laboratory monitoring was carried out, including blood cultures on the days 7 and 48 and after 3, 6, and 12 months.
38 patients in each group were evaluable at the end of treatment. 3 group A patients and 1 group B patient had initial therapeutic failure. 31 group A patients and 35 group B patients could be followed up during 6 months or more (mean follow up of 10.5 and 11.5 months, respectively). 9 relapses (29%) developed in group A and 2 (6%) in group B (p less than 0.05). 22 patients of the 34 finally evaluated in group A (65%) were considered as cured, versus 33 of the 36 in group B (92%) (p less than 0.01). Side effects not requiring withdrawal of the treatment developed in 12 patients, without differences between the two groups.
In the therapy of human brucellosis, the association of doxycycline (45 days) and rifampin (21 days) is less effective than the classical association of doxycycline and streptomycin.
比较和评估两种治疗方案在人类布鲁氏菌病中的疗效和安全性。
一项对比、随机、多中心、开放性研究，比较初始21天使用强力霉素加利福平（A组）与初始14天使用强力霉素加链霉素（B组），疗程均为45天。每组纳入42例患者。布鲁氏菌病的诊断基于血培养或一致的临床发现以及Wright血清凝集效价为1/160或更高。进行临床和实验室监测，包括在第7天、第48天以及3、6和12个月后进行血培养。
治疗结束时每组有38例患者可评估。A组有3例患者和B组有1例患者初始治疗失败。31例A组患者和35例B组患者可随访6个月或更长时间（平均随访时间分别为10.5个月和11.5个月）。A组发生9例复发（29%），B组发生2例复发（6%）（p<0.05）。A组最终评估的34例患者中有22例（65%）被认为治愈，而B组36例中有33例（92%）（p<0.01）。12例患者出现无需停药的副作用，两组之间无差异。
在人类布鲁氏菌病治疗中，强力霉素（45天）与利福平（21天）联合使用的效果不如强力霉素与链霉素的经典联合使用。
